An Update on the Global Burden and Socioeconomics of Scabies A Cross-Sectional Analysis from the Global Burden of Disease Study 2017

Main Article Content

Katelyn Urban
Rachel Lynn Giesey
Maria Delost
Gregory Raymond Delost

Keywords

Age-standardized prevalence rates, Disability adjusted life years (DALYs), Global medicine, Global Burden of Disease Study (GBD) database, Gross domestic product (GDP) per capita, Health care disparities, Infectious disease, Scabies

Abstract

Introduction: Scabies represents a significant burden worldwide, but epidemiologically, how it relates to socioeconomic status, and impact of recent global interventions remains largely unknown.

Methods: We analyzed global scabies trends from 2015 to 2017 in 195 countries worldwide through the Global Burden of Disease Study (GBD) database, including age-standardized prevalence rates, relationship to comorbidities, and age and sex patterns. We also compared scabies burden to a country’s socioeconomic status by using disability-adjusted life years and socio-demographic index, respectively. 

Results: The age-specific prevalence rate in 2017 demonstrated a right skewed distribution with a peak between 15 and 20 years of age, and a roughly equal male:female ratio across all ages. Scabies burden was higher in resource-poor countries. The world regions of Oceania, Southeast Asia, East Asia, and tropical Latin America had the greatest prevalence of scabies. The individual countries with highest scabies burden were Papua New Guinea (age-standardized DALYs 148.2), Solomon Islands (140.5), Kiribati (139.9), Timor-Leste (138.2) and the Maldives (134.9). A positive linear relationship exists between scabies burden and burden of rheumatic fever and bacterial skin disease.

Conclusion: The burden of scabies is highest in children, adolescents, tropical climates, and low income countries. Rheumatic fever and bacterial skin disease burden is higher in areas where scabies burden is also higher. These global data may potentially serve as a purposeful measure for directing resources to improve the global burden of scabies. 

References

1. Metrics: Disability-Adjusted Life Year (DALY). World Health Organization. https://www.who.int/healthinfo/global_burden_disease/metrics_daly/en/. Accessed June 22, 2020.

2. Frequently asked questions. IHME. http://www.healthdata.org/gbd/faq. Accessed June 22, 2020.

3. Leach-Kemon K. A new way of measuring development helps assess health system performance. IHME. http://www.healthdata.org/acting-data/new-way-measuring-development-helps-assess-health-system-performance. Published 2017. Accessed June 22, 2020.

4. Karimkhani C, Colombara DV, Drucker AM, et al. The global burden of scabies: a cross-sectional analysis from the Global Burden of Disease Study 2015. The Lancet. 2017;17(12):1247-1254.

5. Mehrmal S, Uppal P, Giesey R, Delost G. Identifying the prevalence and disability-adjusted life years of the most common dermatoses worldwide. J Am Acad Dermatol. 2020;82(1):258-259.

6. Engelman D, Kiang K, Chosidow O, et al. Toward the global control of human scabies: Introducing the International Alliance for the Control of Scabies. PLoS Negl Trop Dis. 2013;7(8):e2167.

7. Engelman D, Fuller LC, Steer AC. Consensus criteria for the diagnosis of scabies: A Delphi study of international experts. PLoS Negl Trop Dis. 2018;12(5):e0006549.

8. Frequently asked questions. IHME. http://www.healthdata.org/gbd/faq. Accessed June 22, 2020.

9. Protocol for the global burden of diseases, injuries, and risk factors study (GBD). In: Institute for Health Metrics and Evaluation; 2018.

10. Seth D, Cheldize K, Brown D, Freeman EF. Global Burden of Skin Disease: Inequities and Innovations. Curr Dermatol Rep. 2017;6(3):204-210.

11. Parks T, Smeesters PR, Steer AC. Streptococcal skin infection and rheumatic heart disease. Curr Opin Infect Dis. 2012;25(2):145-153.

12. Romani L, Whitfeld MJ, Koroivueta J, et al. Mass drug administration for scabies - 2 years of follow-up. N Engl J Med. 2019;381(2):186-187.